Source: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/downloads/9_Record_Smoking_Status.pdf
Eligible Professional
Meaningful Use Core Measures
Measure 9 of 14
Stage 1
Last Updated: April 2013
Record Smoking Status
Objective
Record smoking status for patients 13 years old or older.
Measure
More than 50 percent of all unique patients 13 years old or older seen by the EP have
smoking status recorded as structured data.
Exclusion
Any EP who sees no patients 13 years or older.
Table of Contents
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Definition of Terms
Attestation Requirements
Additional Information
Related Meaningful Use FAQs
Certification and Standards Criteria
Definition of Terms
Unique Patient – If a patient is seen by an EP more than once during the EHR reporting period, then for
purposes of measurement that patient is only counted once in the denominator for the measure. All the
measures relying on the term ‘‘unique patient’’ relate to what is contained in the patient’s medical
record. Not all of this information will need to be updated or even be needed by the provider at every
patient encounter. This is especially true for patients whose encounter frequency is such that they
would see the same provider multiple times in the same EHR reporting period.
Attestation Requirements
NUMERATOR / DENOMINATOR / EXCLUSION
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DENOMINATOR: Number of unique patients age 13 or older seen by the EP during the EHR
reporting period.
NUMERATOR: Number of patients in the denominator with smoking status recorded as
structured data.
EXCLUSION: An EP who sees no patients 13 years or older would be excluded from this
requirement. EPs must enter ‘0’ in the Exclusion box to attest to exclusion from this
requirement.
The resulting percentage (Numerator ÷ Denominator) must be more than 50 percent in order for an EP
to meet this measure.
Additional Information
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The provider is permitted, but not required, to limit the measure of this objective to those
patients whose records are maintained using certified EHR technology.
This is a check of the medical record for patients 13 years old or older. If this information is
already in the medical record available through certified EHR technology, an inquiry does not
need to be made every time a provider sees a patient 13 years old or older. The frequency of
updating this information is left to the provider and guidance is provided already from several
sources in the medical community.
Related Meaningful Use FAQs
To see the FAQs, click the New ID # hyperlinks below, or visit the CMS FAQ web page
at https://questions.cms.gov/ and enter the New ID # into the Search Box, clicking the “FAQ #” option to
view the answer to the FAQ. (Or you can enter the OLD # into the Search Box and click the “Text”
option.)
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If an EP is unable to meet the measure of a meaningful use objective because it is outside of the
scope of his or her practice, will the EP be excluded from meeting the measure of that
objective? New ID #2883, Old #10151
What do the numerators and denominators mean in measures that are required to demonstrate
meaningful use? New ID #2813, Old #10095
For EPs who see patients in both inpatient and outpatient settings, and where certified EHR
technology is available at each location, should these EPs base their denominators for
meaningful use objectives on the number of unique patients in only the outpatient setting or on
the total number of unique patients from both settings? New ID #2765, Old #10068
How does an EP determine whether a patient has been "seen by the EP" in cases where the
service rendered does not result in an actual interaction between the patient and the EP, but
minimal consultative services such as just reading an EKG? Is a patient seen via telemedicine
included in the denominator for measures that include patients "seen by the EP"?
New ID #3307, Old ID #10664
When a patient is only seen by a member of the EP's clinical staff during the EHR reporting
period and not by the EP themselves, do those patients count in the EP's denominator?
New ID #3309, Old ID #10665
Should patient encounters in an ambulatory surgical center be included in the denominator for
calculating that at least 50 percent or more of an EP's patient encounters during the reporting
period occurred at practices/locations equipped with certified EHR technology?
New ID #3065, Old ID #10466
If an EP sees a patient in a setting that does not have certified EHR technology but enters all of
the patient’s information into certified EHR technology at another practice location, can the
patient be counted in the numerators and denominators of meaningful use measures?
New ID #3077, Old ID #10475
Certification and Standards Criteria
Below is the corresponding certification and standards criteria for electronic health record technology
that supports achieving the meaningful use of this objective.
Certification Criteria
§170.302(g)
Smoking
status
§170.302(n)
Automated
measure
calculation
Standards Criteria
N/A
Enable a user to electronically record, modify, and retrieve the smoking status of a
patient. Smoking status types must include: current every day smoker; current some
day smoker; former smoker; never smoker; smoker, current status unknown; and
unknown if ever smoked.
For each meaningful use objective with a percentage-based measure, electronically
record the numerator and denominator and generate a report including the
numerator, denominator, and resulting percentage associated with each applicable
meaningful use measure.